Comprehensive Evaluation of Kawasaki Disease With Electrocardiogram-gated Cardiac Multidetector Computed Tomography

Abstract

We present a case of a young woman with Kawasaki disease who was comprehensively evaluated by electrocardiograph-gated cardiac multidetector computed tomography (MDCT). MDCT disclosed 3-vessel giant coronary arterial aneurysms and associated focal apical septal myocardial pathology. This was characterized by an early enhancement defect, myocardial thinning, and hypokinesia. These findings are likely due to focal ischemic insult resulting from distal embolization of thrombus material from the giant proximal right coronary arterial aneurysms. This case illustrates the full capabilities of MDCT in the comprehensive evaluation of Kawasaki disease.

Coronary Artery Aneurysm in Kawasaki Disease: Coronary CT Angiography through the Lens of Pathophysiology and Differential Diagnosis

“…CCTA can display all segments of the coronary tree including distal lesions. These regions are known to be problematic and suboptimally imaged with TTE, which can typically only show ostial and proximal segments of the coronary arteries (94,99,102,117). CCTA can also reveal the entire length of a given coronary artery including distal segments that are poorly seen with TTE.…”